摘要
目的探索多学科诊疗模式在代谢手术中的应用价值。方法回顾性分析2011年11月至2014年11月在南京大学医学院附属鼓楼医院接受腹腔镜Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass,LRYGB)治疗的105例患者的临床资料。所有患者均签署知情同意书,符合医学伦理学规定。其中男34例,女71例;平均年龄(40±13)岁。术前和术后不同时点检测患者的体质指数(body mass index,BMI)、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、收缩压(systolic blood pressure,SBP)和甘油三酯(triglyceride,TG)水平。手术前后临床指标的比较采用t检验。结果患者的BMI、FPG、HbA1c、SBP和TG水平均在术后6个月内呈下降趋势。术后1个月,患者的BMI为(33±6)kg/m^2,明显低于术前的(37±7)kg/m^2(t=18.841,P<0.05);FPG为(5.7±1.6)mmol/L,明显低于术前的(7.8±3.0)mmol/L(t=2.726,P<0.05);HbA1c为(6.5±1.2)%,明显低于术前的(7.6±1.7)%(t=4.708,P<0.05);SBP为(133±17)mm Hg,明显低于术前的(147±15)mm Hg(t=4.063,P<0.05);TG为(1.7±0.7)mmol/L,明显低于术前的(2.9±1.2)mmol/L(t=4.272,P<0.05)。结论多学科诊疗模式下的代谢手术具有安全、可靠等优点,值得在临床中推广使用。
Objective To investigate the application value of multidisciplinary treatment mode in metabolic surgery. Methods Clinical data of 105 patients undergoing laparoscopic Roux-en-Y gastric bypass(LRYGB) in Gulou Hospital Affiliated to Medical college of Nanjing University from November 2011 to November 2014 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 105 patients, 34 were males and 71 were females with an average age of(40±13) years old. Levels of body mass index(BMI), fasting plasma glucose(FPG), glycosylated hemoglobin A1c(HbA1c), systolic blood pressure(SBP) and triglyceride(TG) were tested before and at different time points after operation. Clinical indexes before and after operation were compared using t test. Results Levels of BMI, FPG, Hb A1 c, SBP and TG appeared to decrease within 6 months after operation. At 1 month, BMI was(33±6) kg/m^2, which was significantly lower than(37±7) kg/m^2 before surgery(t=18.841, P<0.05); FPG was(5.7±1.6)mmol/L, which was significantly lower than(7.8±3.0) mmol/L before operation(t=2.726, P<0.05); Hb A1 c was(6.5±1.2)%, which was significantly lower than(7.6±1.7)% before operation(t =4.708, P<0.05); SBP was(133±17) mm Hg, which was significantly lower than(147±15) mm Hg before operation(t=4.063, P<0.05); and TG was(1.7±0.7) mmol/L, also lower than(2.9±1.2) mmol/L(t=4.272, P<0.05). Conclusion Metabolic surgery in multidisciplinary treatment mode has the advantages of safety and reliability, which is worthy of popularizing in clinic.
出处
《中华肥胖与代谢病电子杂志》
2016年第1期12-16,共5页
Chinese Journal Of Obesity and Metabolic Diseases：Electronic Edition
基金
南京市科技基金发展项目(YKK14066)
关键词
多学科诊疗模式
代谢手术
肥胖症
糖尿病
2型
Multidisciplinary treatment mode
Metabolic surgery
Obesity
Diabetes mellitus,type 2
